• Kazuhito Takeuchi, Fumiharu Ohka, Yuichi Nagata, Sachi Maeda, Kuniaki Tanahashi, Yoshio Araki, Taiki Yamamoto, Hiroo Sasaki, Akihiro Mizuno, Hideyuki Harada, and Ryuta Saito.
• Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan. Electronic address: ktakeuchi@med.nagoya-u.ac.jp.
• World Neurosurg. 2022 Nov 1; 167: e1147e1153e1147-e1153.

ObjectiveThe biopsy procedure is intended to obtain an adequate specimen volume from the targeted area while ensuring minimal damage to the normal brain. We performed navigation-guided endoscopic biopsy using a small-diameter cylinder to reduce the invasiveness of the biopsy procedure and ensure a sufficient amount of tissue is collected. We examined whether it is possible to reduce brain tissue injury by using a small-diameter cylinder and improve safety and effectiveness by using an endoscope to directly observe the lesion and achieve hemostasis.MethodsPatients who underwent endoscopic biopsy surgery using a 6-mm-diameter cylinder for intraparenchymal lesions were enrolled in this study. Postoperative hematoma formation and the extent of trajectory scarring were assessed.ResultsFifty-two procedures performed on 51 patients were analyzed in this study. Postoperative neurological deterioration was not observed in any patient. A pathological diagnosis was made for all patients. Postoperative computed tomography revealed no hematoma after 49 procedures and a small hematoma after 3 procedures, and no patients required additional treatment. A postoperative trajectory scar less than 5 mm in diameter was observed after 30 procedures, a scar of 5-10 mm was observed after 19 procedures, a scar larger than 10 mm was observed after 3 procedures at 1 week after surgery, and 40, 6 and 0 scars were observed at 3 months after surgery.ConclusionsEndoscopic biopsy using a small-diameter cylinder is a possible alternative biopsy technique for intraparenchymal lesions. This surgical technique is useful, especially in patients at risk of hemorrhagic complications.Copyright © 2022 Elsevier Inc. All rights reserved.

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